Abstract

Background Endothelial dysfunction is considered as a link between chronic, systemic inflammatory process in rheumatoid arthritis (RA) and initiation of atherosclerosis process. Microvascular dysfunction may precede the beginning of atherosclerosis and predispose RA patients to development of cardiovascular disease (CVD) (1). In patients with longstanding RA, microvascular function is impaired and associated with activity of disease (DAS28).

Recently, it has been demonstrated that microvascular endothelium-dependent vasodilatation and capillary recruitment is preserved in early disease-modifying antirheumatic drugs (DMARD)-naive patients (2). However, there is no information about skin hyperaemic heat response which is an integrated index of neurovascular and nitric oxide-dependent cutaneous blood flow regulation (3).

Objectives Present study was performed to investigate disorders in macro- and microcirculation in newly diagnosed, (DMARD)-naive patients with RA and healthy controls.

Results There were no significant differences between groups in values of BP, BMI, WHR and levels of lipids and glucose. As expected patients with RA had significantly higher CRP, ESR, hsTNFalfa and hsIL6 levels. VWF (%) was also higher in RA patients (109,75±48,6 vs 73,7±22,39, p=0,005). The study groups were similar in IMT, however differed in LDF parameters of flow during local heat stress. Time to maximal heat flow (sec) was increased [17,01±4,35 vs 11,14±5,36 (p=0,04)] and maximal heat flow velocity (U/min) was lower [10,43±5,49 vs 24,67±24,1 (p=0,03)] in patients with RA. All results were age and sex standardized.

Conclusions Microvascular dysfunction preceding the onset of atherosclerosis in early active rheumatoid arthritis is represented by alteration in microcirculation response to thermal stress.

Statistics from Altmetric.com

No Altmetric data available for this article.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.